CASE STUDY - OBESITY
Patient:
Jane, 40 years, works as a cashier at Tesco, has 2 children (22 and 15 years), is divorced.
The big problem is obesity, she had fattened during pregnancy, since then she is trying to lose
weight. Almost always "loses weight" with mixed success, lost pounds always return back
quickly. She istrying different types of popular diets or a hunger strike and then she resigns.
Height 171 cm, weight 96 kg. Smoker, daily 3 to 5 coffees, irregular diet, at work she practically
eats a bit when she has time, usually some bakery and salty bars, and when she comes home
from work, usually bread with pate or sausage, hot meal is 2 to 3 times a week, she doesn’t
sport, during her leisure time she is watching television or "walks" to the mall where she
works.
Weight 96 kg, height 171 cm.
Personal history:
At 32 years of age had the removal of the gallbladder, since then digestive problems persist
(constipation, bloating, nausea, heartburn places), pregnancy diabetes, varicose veins,
suffering from insomnia, headaches, back pain, it still bothers her nervousness, fear of the
future - the existential difficulties and problems with a younger son.
Two months ago, demonstrated hypertension (BP 168/120), deployed medication Enap 5, 1x1,
the patient admits that "sometimes, actually quite often" missed the dose. Sometimes feels
pushing on the chest, palpitations, yet not examined by the doctor.
Drug history: Enap 5mg 1 - 0 – 0
Lexaurin 3mg as needed, but at least 2-3 times a week
Stilnox as needed
Pancreolan forte as needed
Ibuprofen 400 for pain
The doctor advised her to lose weight for health reasons, the patient asks if there are any pills
for weight loss, "because diet and nothing holds still".
Tasks:
1. Describe obesity as a disease. What is the pharmacological and surgical treatment of
obesity?
2. Perform an analysis of prescription drugs, give active substance classification
according to ATC classification, a brief mechanism of action of individual products,
check the dosage and method of use (morning / evening, before / after meals, etc.)
3. What other medical tests are appropriate for the patient?
4. What medicines can be taken to promote weight loss?
5. Are those medicines suitable for this patient?
6. What dietary supplements do you recommend the patient?
7. What dietary recommendations will you suggest?
8. What regimen measures will you suggest to the patient?
9. Estimate the patient's degree of cooperation, factors that worsen the condition and
the possibility of improvement.